These are among the most frequent and most serious illnesses of early infancy. They may result from mechanical causes, such as a mass of undigested food, which produces increased intestinal secretion and peristalsis; from the action of bacteria, or their toxins, together with the inability of an enfeebled digestive tract to meet the needs of a rapidly growing body; or from such reflex causes as sudden chilling of the body, excitement, fatigue or the prostration resulting from excessively hot weather.
Acute gastro-enteritis, the diarrheal disease which is so common and so fatal during the hot months of July and August, is often referred to as “summer complaint” or “summer diarrhea.” It is so largely avoidable through good nursing that the methods of its prevention were described in connection with the care of the baby during the Summer, resolving itself, as it does, into feeding the baby properly and keeping him clean and cool and quiet.
Symptoms. While there are different forms of summer diarrhea, the general symptoms are much the same and may develop gradually after some evidence of indigestion, or suddenly with a rise of temperature to 101° F. or 102° F., or even as high as 106° F., accompanied by pain and vomiting. The baby is usually restless, fretful and thirsty and his skin is hot and dry. He gives evidence of pain by shrill crying, drawing up his legs and flexing them on his abdomen. Diarrhea is the conspicuous symptom and there may be anywhere from four to twenty movements in the course of 24 hours. The stools are largely fecal matter at first but they finally become fluid and contain mucus. They may be expelled with a good deal of force and a quantity of gas come with them. The baby grows very weak, thin and hollow-eyed, if the diarrhea persists and unless promptly treated the end may be fatal.
Treatment and Nursing Care. The first step is to stop all food and to give water freely. When water is not retained by mouth it is frequently given by rectum, into the tissues or intraperitoneally. The pain may be relieved by applying hot stupes.
Feeding is resumed very gradually and cautiously for one attack of summer complaint predisposes to another and every precaution is taken to prevent a recurrence. Thin barley water or broth is usually given first, followed by whey, protein milk, buttermilk or diluted skim-milk in small amounts and at comparatively long intervals.
Chart 6.—Weight chart showing normal loss and gain during the first fourteen days of life.
Chart 7.—Chart showing loss of weight in inanition fever.
